Excerpted from the Policy Statement on Breastfeeding from the American Academy of Pediatrics.
1. Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions. The ultimate decision on feeding of the infant is the mother’s. When direct breastfeeding is not possible, expressed human milk, fortified when necessary for the premature infant, should be provided.
2. Breastfeeding should begin as soon as possible after birth, usually within the first hour.
3. Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger.
4. No supplements (water, glucose water, formula, and so forth) should be given to breastfeeding newborns unless a medical indication exists. With sound breastfeeding knowledge and practices, supplements rarely are needed. Supplements and pacifiers should be avoided whenever possible and, if used at all, only after breastfeeding is well established.
5. When discharged before forty-eight hours after delivery, all breastfeeding mothers and their newborns should be seen by a pediatrician or other knowledgeable healthcare practitioner when the newborn is two to four days of age. In addition to determination of infant weight and general health assessment, breastfeeding should be observed and evaluated for evidence of successful breastfeeding behavior.
6. Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first six months after birth. Gradual introduction of iron-enriched solid foods in the second half of the first year should complement the breast-milk diet. It is recommended that breastfeeding continue for at least twelve months and thereafter for as long as mutually desired.
7. In the first six months, water, juice, and other foods are generally unnecessary for breastfed infants.
8. Should hospitalization of the breastfeeding mother or infant be necessary, every effort should be made to maintain breastfeeding, preferably directly, or by pumping the breasts and feeding expressed breast milk, if necessary.